What would you recommend to remove "smoker lines" above the lip?

Question

A doctor injected a filler in my lips which resulted in a very defined pout. Frazel has been suggested by another surgeon. Any suggestions?

J. Jason Wendel, MD, FACS · Answer

Thank you for your question.Fine lines and wrinkles around the mouth can often be treated with full surface peri-oral laser resurfacing

To be sure that something like this might be right for you, see two or more experienced, licensed
and certified providers for a complete evaluation to make sure you are a good
candidate and that it is safe for you to have the procedure.

I hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Vivek Bansal, MD · Answer

Thank you for your question. For perioral furrows, my preference is laser resurfacing.  Soft tissue fillers can also be helpful for deeper lines. I hope this helps!

Timothy R. Miller, MD · Answer

There are generally three very effective options for lip lines: Fractional or full CO2  laser, fillers, and Botox, with Ultherapy being a fourth option.CO2 laser treatments are considered the gold standard for treating lip lines but this does require some "downtime" but the results last several years if not longer.  Fillers can be effective as well if the lines are deep enough but too much filler can cause the lip to appear too full.  Botox is reasonably effective and definitely limits the progression of lines and wrinkles too.The attached link and website provides more inforamtion.I hope this helps.

Jose Barrera, MD · Answer

There are many options available to treat smoker's lines. Botox can reduce the lines but can also slightly lengthen the lips. Fillers are great to accentuate the lips but will not affect lines in the white lip. CO2 laser resurfacing can reduce the lines and also provide a slight improvement in volume of the red and white lip.

David Hansen, MD · Answer

I prefer to put a very soft ptfe implant that looks like a spaghetti noodle in the vermillion border of the lip. This is easily done under local and takes less than 20 min to permanently correct the problem and looks natural for roughly $1500-2000 per implant. Often a medium TCA chemical peel is also great to improve the area as well. Lasers are ok but more expensive than peels for the same results. Botox is to be avoided since there are often problems with trying to get even results from it. Filler are ok but temporary. Sincerely, David Hansen,MD

Suzanne Kilmer, MD · Answer

My favorite is ablative laser
resurfacing as you can erase the lines - it is more invasive but gets the job
done. You can use milder forms of laser like Fraxel but not as much improvement
occurs. Also, using Botox in conjunction with whatever treatment you choose will
help decrease the muscles from making the lines so your chosen treatment is
more effective. Fillers can definitely help but they need to be the thinner
ones so they don’t bulk up the lip.

Michael H. Gold, MD · Answer

Thanks for your
question and you do have many options available – all determined on how things
really look, so a picture would have been very helpful. I would recommend
consulting with a board-certified dermatologist or plastic surgeon and then
decide on the best approach – using fillers and/or toxins with or without an
appropriate laser or light source. Several of the fillers work well here when
injected by very skilled injectors. Belotero and the new Restylane Silk would
be the go-to fillers for this area and your concern. In addition, lasers,
whether an erbium “peel” procedure or one of the non-ablative fractional
devices like what is being recommended or the ablative fractional devices would
all work here. Consult with a board-certified dermatologist or plastic surgeon,
learn the options, and chose the one(s) that work best for you.

Margaret Weiss, MD · Answer

Smoker's lines can be a tough problem to treat. Strong carbon dioxide resurfacing can be harsh with long healing time and many side effects. An effective treatment might be a combination of gentle laser resurfacing (such as Fraxel or Icon XD), ultrasound (Ultherapy), radiofrequency (Infini) with a superficial filler like Restylane Silk or Belotero, in addition a little neuromodulator to decrease puckering. There is no magic bullet yet.

Laxmeesh Mike Nayak, MD · Answer

Treatment of upper lip lines ("smoker's lines") ranges from Botox injection (mildly effective) to filling each individual line (moderately effective) to dermabrasion or laser resurfacing (mildly to very effective, depending on depth).In general, in darker skin tones, or individuals that cannot take a prolonged recovery, filling each individual line with Juvederm or similar product generates excellent results for a year or more at a time. This type of treatment is best for a walk in/walk out minimal or no downtime treatment.In lighter-skinned individuals who can accept a prolonged recovery (because, for instance, they are also having a facelift), laser resurfacing is generally a better choice.